Friday, April 30, 2010

the anniversary of greatness and misery

First, the good.

Today is our fifth wedding anniversary. We are still very much in love, wonderful friends, and enjoying our marriage. I couldn’t ask for more. I’m truly blessed and looking forward to the rest of our lives together.

It is also an anniversary of great sadness. Two years ago today we were PNGd from Belarus. You can read this previous post for the full story. I keep hoping that as time passes, I will begin to forget and forgive, but I’m just not there yet. For those of you in the FS, may you never, ever have to live through such a horrible experience.

There isn’t much else to say. Have a safe and happy weekend.

Thursday, April 29, 2010

email from company B and another phone call

This is not looking good. I finally received a response from Company B regarding the insurance fiasco I’ve been dealing with since January. I almost didn’t open the email as there was no indication that it was from Company B or had any affiliation with, and the subject was just bizarre. “*********three letters********” And the three letters were completely random.

Against better judgment, I opened it, fortunately. Yes, I opened it and read such things as

“We have received notification from our Marketing Department that you are requesting assistance in getting overseas claims processed due to the fact that Ireland does not bill medical services or provide the same information that is required for claims submitted in the United States.”

Why it went through the Marketing Department is beyond me, though I probably shouldn’t be surprised. I suppose I should be grateful that they finally grasp that Ireland doesn’t bill for services the way physicians in the U.S. do, but isn’t that the point of paying for “overseas coverage?”

Another gem:

“We do understand that services rendered overseas are handled differently than in the United States; however, ‘Company B’ is required to administer the contract as it is written.”

Contract as written, what???? I don’t care what they claim their contract says. In the paperwork that I have, nowhere does it say that overseas providers must handle billing similarly as is done in the U.S. Again, isn’t that the point of “overseas coverage?” They finally acknowledge that services and payment are handled differently “overseas.” Clearly I’m missing something as to why they won’t pay these claims.

Well, at least they are no longer asking for CPT codes, but it doesn’t change the fact that they are not going to pay for ANYTHING.

This afternoon I was back on the phone with Company B for 45 minutes. After much back and forth, the woman I was speaking to said that they could at least cover the blood work if I could get a breakdown of dates and blood tests from the lab. Are you kidding me? Was she referring to the same lab that won’t even give me a copy of my blood work results? Yeah, good luck getting a breakdown of services and prices.

Just an FYI, I was speaking to another FS spouse earlier this week and she had the same problem with Company B. Fortunately she had a “normal” pregnancy, obstetric care was less expensive, and her doctor worked with the hospital billing department, so after a year of fighting, she was finally reimbursed. She also delivered here so was reimbursed via the “fund site.” It appears that I won’t be so lucky.

And so, here we are, my head still spinning, my claims still unpaid.

Thursday, April 22, 2010

more to add to the story.......

You know, the story that’s going in the book I plan to write when my husband retires. Which right now, feels like a billion years away.

Today I had meetings, lots and lots of meetings. Unfortunately I can’t share the nature nor the outcome of said meetings, but oh will they ever go in my “tell all” book. There is one situation in particular that has been dragging on since oh, we arrived, 19 months ago. You FS peeps can probably imagine what this pertains to and why I’m the one dealing with it.

To be fair, I’m sure that some of the responsibility lies with me because after the first solid 10 months of dealing with said situation, I backed off, got lazy, felt defeated, whatever you choose to believe. Well, now we’re expecting a baby and I want things done. Personally I think that 19 months is more than enough time, but I’m not in the FS, I’m just a spouse, so what do I know.

In January, some new department heads came in, so I brought the situation to their attention. Then went through the “proper” channels and procedures, and hoped for resolution. Wishful thinking. Then it went to person A, then to person B (both of whom I met with and both of whom had wildly different ideas on policies and procedures). Then department X was brought in, then department Y and Z, add person C, D, and F. Then add two meetings with person F, and jumping through all of the hoops that person F asked for. Well, now enter person G who is dealing with the aftermath that person F left in his/her trail, prior to leaving forever and ever. Goodbye

I will say that my favorite part of all of this has been when people look me right in the face, smile, and tell me to enjoy the pregnancy. Umm, not sure which part I’m supposed to enjoy, dealing with the above situation every.single.day, fighting with Company B for maternity coverage, injecting heparin into my sore, bleeding body twice a day. (Yes, I’m beyond thankful to be pregnant; it would just be a lot more pleasant if life were somewhat normal)

So here we are, no resolution, more meetings scheduled for tomorrow and next week, and true to the FS way, even more people getting involved.

Err, which part of this is fun?

And PS, going to the pharmacy after leaving the meeting only to find out that I need a ****** prescription for baby aspirin did NOT help my already foul mood.

Wednesday, April 21, 2010

TMI at the maternity store

This is probably one of those, ‘you had to be there’ situations, but it was so over the top, that I couldn’t not share it with blogland.

One of the reasons for my trip to the U.S. was to buy maternity clothes; ordering online just doesn’t work for some items. I hit the usual stores, Pea In the Pod and Gap Maternity, then headed over to Motherhood Maternity to have a look.

While browsing through the racks, a young (maybe 25ish) woman came into the store and when approached by the saleswoman, loudly announced that she wasn’t pregnant yet, but planned to start trying next year and wanted to buy some maternity clothes. Upon hearing this, my ears perked up and I wanted to scream “RUN, don’t do this to yourself, your body might not cooperate, don’t set yourself up for heartache.” Granted, 3 ½ years of infertility has colored my perspective on “preparing” for life events.

I continued to shop and finally headed toward the dressing rooms to try on a few items. Oh lucky me, Ms. ‘I’m not pregnant yet’ or even trying, went into the room next to mine.

For the next 20 minutes, I tried, and failed, to block out the TMI I heard from the dressing room next door, as did my mom and probably every other sane person in the store. Ms. ‘I’m not pregnant yet’ shared ALL about her life, including, but not limited to, her choice of birth control, her husband’s ex-girlfriend’s choice of birth control and decision to stop taking it without telling him, her house and how old it is, and her debt. Seriously. I kept peeking out of the dressing room and giving my mom the “Are you kidding me” look, to which she’d shake her head. I suppose the only saving grace to this craziness is that Ms. ‘I’m not pregnant yet’ had also informed the entire store that her husband didn’t want to start a family until they had lowered their debt, which judging by the amount of maternity clothes she was buying, would not happen for a long time. And while she was definitely a customer, it should also be noted that there was a line of visibly uncomfortable, pregnant women waiting for a dressing room.

Like I said, it was probably one of those situations in which you had to be there, but while it was happening, it was certainly entertaining.

Words to the wise: keep your personal information to yourself, especially in a store full of strangers.

Friday, April 16, 2010

42

Yes, 42. That is the number of times I’ve spoken to our health insurance company since January. Yes, I’ve kept track, not only of the number of times I’ve called, but the length of each call. Most were well over an hour, or close to.

For those of you in the Foreign Service, you know that we have the choice of two health insurance companies for overseas coverage. For the purpose of this post, we shall call them Company A and Company B. We have Company B.

Overall, I’ve been very pleased with Company B. They don’t offer ANY infertility coverage (another post for another time) and yes, their rates are high, but the coverage in the U.S. is phenomenal. All of my specialists in Scottsdale, Arizona are on the “preferred provider” list and rarely do I owe much more than the copay. Happy. Overseas, Company B has caused many, many tears, panic attacks, fits of rage, etc, etc, etc.

So, why have I called Company B 42 times? In January when I booked my first appointment with the high-risk OB, his secretary explained the billing set up to me. Prenatal care (not delivery) is €4,000. The first payment of €1,000 is due at the first visit. Remaining payments of €1,000 are due at subsequent visits. Sounded fine to me, ALL of the other OBs I’d called, or our health unit had called, had similar billing practices. I called Company B and asked what paperwork I would need to be reimbursed. (For those not familiar with the Foreign Service, overseas we have to pay for all of our medical care upfront, then go after the insurance company for reimbursement. Um yeah, NOT fun). Company B told me that I would need to submit the receipts and dates. Ummm, “Are you sure”? Oh yes, I was reassured during FOUR separate phone calls. Believing this to be too easy, at the first visit/ first €1,000 payment, I asked the secretary to type up a specific letter for me to submit to Company B, clearly spelling out the payment practice. Over the next few months, Company B received the claims for three payments of €1,000, with receipts, with the standard explanation of payment given to all patients, AND with the letter written specifically for me. DENIED, DENIED, DENIED

And so began the phone calls……

First I was told, many times, that I needed CPT codes. WHAT????? I live in I.R.E.L.A.N.D; there are no CPT codes. CPT codes exist in the U.N.I.T.E.D S.T.A.T.E.S (remember, I am speaking with the “federal overseas customer service department”). After much frustration, they seem to finally believe that CPT codes indeed don’t exist in Ireland. Then I was told that I need to include dates of service. Err, did you NOT see the paperwork included that spells out the payment set up? Then I was told they wouldn’t cover “prepayment of services”. Again, did you NOT see the paperwork included?

Throughout the phone calls I have remained calm, avoided “choice” words that I sooooo felt like using, and somehow managed not to scream at anyone. I have asked for supervisors, read them the paperwork, offered to get additional letters from my doctor, letters from the embassy health unit, etc. Nope, nothing is good enough. I have tried to explain that as an American, I can’t go into another country and expect them to change their billing scheme to fit my needs. I’m paying (a lot) for “overseas coverage” and I expect to be, you guessed it, covered overseas. Then I hear, “You do have overseas coverage”. No, “I’m paying for coverage, but clearly, I’m not covered.”

As of last week, I was told to just resubmit everything after the baby is born. Err, so I’m supposed to be out almost $6,000 for several months with no guarantee of reimbursement? Don’t think so. Plus, what Company B can’t seem to grasp is that the €4,000 (roughly 6K USD based on exchange rates at the time) does NOT include delivery fees, even though all of the paperwork clearly states “does NOT include delivery fees” in BOLD letters. So then I ask, “So, if I wait until late July and submit all maternity expenses and delivery charges, I will be reimbursed”? (at least €8500+) Answer, “No, that would exceed your plan allowance”. My head is going to explode, explode I tell you. I haven't even shared with them the joyous news that I might be delivering in the U.S., I'm sure their main office of operations would internally combust upon hearing that.

Phone call after phone call has ended with tears, hanging up, and sobbing in frustration. Call Washington and ask for help you say. Been there, done that. I was told that this has never been a problem before (riiiiight), to call and speak with a supervisor, and here, try this number. I immediately tried the number and reached Company B “of Georgia”. At that point you could probably see steam coming out of my ears.

Today I’m giving myself the day off (from speaking with Company B). The ‘fun’ will resume on Monday.

Signed,
A Furious American in Ireland

Wednesday, April 14, 2010

VERY happy Guinness update!

I have been very hesitant to post on this topic because it always feels like in the next breath, something could go terribly wrong. However, it also seems unfair to keep such wonderful news from you, particularly with the amount of love, prayers, and good wishes you have sent during this very difficult journey.

While I was making arrangements to go to the U.S., I spoke to both Guinness’ private vet and his vet at UCD regarding my travel plans and apprehension about leaving him. They both assured me that whatever was wrong with Guinness was not life threatening, in that his heart wasn’t going to stop and he would die instantly. The symptoms that plagued my dear boy would not take him while I was away for nearly three weeks. Of course I was comfortable leaving him with my husband, but was nervous because I wouldn’t be around during the day to watch him. It was very difficult to walk out the front door, even with the knowledge that the cats would be well cared for, and knowing how much my husband loves them.

Once I arrived in the U.S., I called daily for updates. For the first several days, I was usually told that Guinness was eating fairly well, having an episode or two, but would usually climb into my husband’s lap and rest until he felt better (usually baby boy is in my lap in the evenings and when he doesn’t feel well). Over the next several days, my husband said that he had been episode free in the evenings, though who knows what was happening during the day when nobody was home to watch them. Days went by and Guinness’ appetite continued to improve, he was actively playing with Bella, and seemingly, episode free. I was thrilled with the news, but nervous that “normal” would return when I got back to Dublin.

When I arrived at home, Guinness ran up the stairs and stared at me cautiously through the rails on the banister. It took several minutes for him to feel safe enough to approach me. Since then, he has been nearly inseparable. I wish I could put into words the drastic change that has occurred. He is nearly 100%, back to normal. He plays, runs up and down the stairs, “talks” all the time, chases Bella, has a hearty appetite, and best of all, he has been episode free for weeks. I wasn’t sure if he would remember our routine of bedtime snacks in the evening, he does. Even better, he not only eats all of his snacks, he then climbs over and lies either on my chest or curls up next to me with his front legs and paws on my chest, often putting his face near mine to give me soft kisses on the nose. He’s quite the snugglepuss.

I don’t know what changed; perhaps the antibiotics helped after all; perhaps he is growing out of horrible symptoms that ravaged his little body for so long. One thing is certain, we couldn’t have come this far without your constant support and loving words. Thank you.

A picture from this afternoon of a very healthy and active Guinness


The fur is coming in nicely on the back of his head.


PS- Bella is doing well too. She is her normal, sassy self and seems to be enjoying that her playmate is feeling good again (the hissing and swatting have ceased). I’ll try to get some pictures of them together in the next few days.

Sunday, April 11, 2010

busy, busy, busy- tales from the trip, part 1

My mom picked me up at the airport on March 17 and the first order of business was shopping and food! We went to Babies R Us, then out for Mexican food. Oh how I had been craving Mexican food. More shopping, then we checked into the Hyatt Regency, ahhhh, a comfortable bed. It had been 20ish hours since I’d slept by that point.

The next day we took her car in for servicing and walked over to Starbucks for breakfast. My latte was PERFECT!! Before we left, I went over to thank the barista for the great drink (a rare experience at my neighborhood Starbucks in Dublin). I’m sure he either thought I was insane or I made his day. Either way, that latte was perfection in a cup. We walked back over to the Volvo dealership and by that time the courtesy driver had returned, so he took us to Mall Of America. My mom had arranged for a loaner vehicle, but none of the cars had been returned from the previous evening. The dealership offered to rent us a car, but since they couldn’t get a Volvo, it was a no-go. (My mom is a “little” protective of her only child and grandchild ;) ).

We had so much fun at the mall. The first stop was Nordstrom, of course, and my mom couldn’t help but buy lots of fun items in the children’s department for her granddaughter. Baby even managed to give a few kicks in approval of the purchases being made.

The next several days were spent in the Minneapolis area, shopping for maternity clothes, putting the registry together, and eating wonderful American food. We then went to northern Minnesota and the shopping came to a temporary halt, for which I’m sure my husband was relieved.

I actually accomplished a lot and aside from deciding on bedding (who knew it would be so hard), ordering a few more of the “big” items, and taking care of last minute things, I’m about done. YAY!

Where have I been? (trip to the U.S.)

The daily trip to Starbucks. Okay, sometimes twice daily trip to Starbucks.

Where after drinking too many of these (my usual iced, grande nonfat latte with extra ice *now half decaf*)


I was introduced to this (vanilla bean frappacino)


My husband thinks I spend entirely too much time here....


Multiple trips to Babies R Us. Who knew babies needed so much stuff?

Yes, those are three different stores :/

food, glorious American food


To my cousin L, I had a cherry Icee at Sam's Club and thought of you.


No trip to the U.S. is complete without stopping at a Target.


Most of the time I didn't have the camera with me, but there were also multiple trips to Costco and I think I managed to hit every American chain restaurant in the greater Minneapolis area. Hey, I hadn't been in the U.S. in 18 months. Give me a break!

Wednesday, April 7, 2010

back in Dublin

Once again, sorry for the lack of posts; I’ve been busy. However, the fun, shopping, and good American food eventually had to come to an end and I’m now back in Dublin. Flying at almost 22 weeks pregnant was uncomfortable, flying at almost 25 weeks was miserable, the thought of flying again at 34ish weeks. EEEEEEKKKKK! Of course it didn’t help that I was flying on one of my least favorite airlines, but it was the only carrier in which I could get a ticket from point A to point B for under $850, barely.

During the next week or so, I’ll post the highlights, and lowlights, of the trip. Hope everyone is doing well and I’m looking forward to catching up on all of your blogs!

PS- Though I was able to avoid “shooting up” during the flight on the way to the U.S., it was unavoidable on the way back to Ireland. Nothing like trying to inject 1ml of heparin into bruised, swollen, sore thighs (more on the location change later), in a tiny lavatory, in turbulence, at 30,000 feet. Good times.